ATI RN
ATI Pediatric Proctored Exam 2023
1. A school-age child is 2 hours postoperative following a tonsillectomy. Which of the following actions should the nurse include in the plan of care?
- A. Place a heating pad at the surgical site.
- B. Encourage the child to cough every 2 hours.
- C. Administer analgesics to the child on a regular schedule.
- D. Apply an ice collar to the child's neck.
Correct answer: D
Rationale: After a tonsillectomy, applying an ice collar to the child's neck helps decrease pain and swelling. Heat should be avoided as it can increase bleeding. Encouraging coughing may increase the risk of bleeding. Administering analgesics on a regular schedule is essential for pain management, but the immediate postoperative period may require additional interventions like ice collar application.
2. A post-op patient has an epidural infusion of morphine sulfate. The patient�s respiratory rate declines to 8 breaths/minute. Which medication would the nurse anticipate administering?
- A. Naloxone (Narcan)
- B. Acetylcysteine (Mucomyst)
- C. Methyprednisolone (Solu-Medrol)
- D. Protamine Sulfate
Correct answer: A
Rationale: Naloxone is a narcotic antagonist that can reverse the effects, both adverse and therapeutic, of opioid narcotic analgesics.
3. A pediatric client is admitted to the emergency department with a traumatic brain injury (TBI) that caused a loss of consciousness. The last set of vital signs showed heart rate 48, blood pressure (BP) 148/74 mmHg, respiratory rate 28 and irregular. What does the nurse suspect based on these data?
- A. Spinal cord injury
- B. Increased intracranial pressure
- C. Typical for sleep
- D. Improvement
Correct answer: B
Rationale: The vital signs of bradycardia, hypertension, and irregular respirations indicate increased intracranial pressure. Bradycardia (heart rate of 48), hypertension (blood pressure of 148/74 mmHg), and irregular respirations are typical signs of increased intracranial pressure in a pediatric client with a traumatic brain injury and loss of consciousness.
4. Parents are speaking with the urologist about their son's undescended testicle. Which statement by the child's father causes the nurse to determine he understands the information presented?
- A. An undescended testicle can reduce fertility.
- B. The testicle usually descends spontaneously during the first month of life.
- C. Surgical correction reduces the risk for testicular tumors.
- D. The optimal time to surgically correct the condition is at diagnosis.
Correct answer: A
Rationale: The correct answer is A because an undescended testicle can reduce fertility. Even after surgical correction (orchiopexy), fertility rates may be reduced, especially when one testis remains undescended. The statement in choice B is incorrect as the testicle should have descended into the scrotum by the time the infant is 4-6 months old. While choice C is true that surgical correction can reduce the risk of testicular tumors, the question focuses on the father's understanding of the information presented, which is better reflected in choice A. Choice D is incorrect because the optimal time for surgical correction of an undescended testicle is typically around 6-18 months of age, not necessarily at the time of diagnosis.
5. What is the priority nursing intervention when caring for a neonate born with bladder exstrophy?
- A. Measuring intake and output
- B. Inserting a Foley catheter
- C. Covering the defect with sterile plastic wrap
- D. Palpating the bladder mass to ensure urine is expelled
Correct answer: C
Rationale: The priority nursing intervention when caring for a neonate born with bladder exstrophy is to cover the defect with sterile plastic wrap. This intervention helps prevent infection and maintains a moist environment, promoting optimal healing and reducing the risk of complications.
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